[VIDEO] Why Do I Need to "Substantiate" My Claim (And How Do I Do It?)

We get a lot of questions from people wondering why they are required to substantiate claims when they pay for medical expenses using their MyAmeriflex Card. The video above explains why substantiation is required and show you how the substantiation process works.

For a more in-depth look into why substantiation is required, you should check out our blog post: "Three Tips to Help Stop Those Pesky Substantiation Documentation Needed Requests," but the biggest reason participants are asked to substantiate a claim is because the IRS requires you to prove that the item or service you bought or received is an eligible expense. Most places offer a mix of both eligible and non-eligible items, like flowers from a hospital gift shop, or sunglasses from an eyeglass provider. Even some expenses from a doctor’s office aren’t eligible, like membership fees for concierge care or Direct Primary Care and most cosmetic procedures.

As a result, you may be asked to provide documentation showing that your purchase was eligible.

How Do I Substantiate an Expense?

If you have a Health Reimbursement Account, or HRA, you will usually need to provide an explanation of benefits, or an EOB form, from the place you received the medical services. This form will include things like the date, the type of service provided, the name of the provider, and the dollar amount. You can then login to the Ameriflex Participant Portal and upload a copy of your EOB. Ameriflex also has a mobile app; which allows you to simply take a picture of the EOB using the camera on your smartphone and upload it using the app.

If you have a Flexible Spending Account (FSA), a Health Savings Account (HSA), a Dependent Care Account (DCA), A Commuter Reimbursement Account (CRA), or a limited Purpose Flexible Spending Account (LPFSA), you may be able to use an itemized receipt instead of an Explanation of Benefits. But remember, it needs to be an itemized receipt that includes the date, the type of service, the name of the provider and a dollar amount of each expense included in the transaction can be used. A standard receipt will not be enough to substantiate a claim.

What if I lost my EOB or Itemized Receipt?

If you lost the EOB or itemized receipt you will most likely need to contact the healthcare provider and ask them for another copy. This is why we recommend that you save a digital copy.

For more information you can go to www.myameriflex.com or call us toll free at 888-868-3539.

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